To date, there is no standard approach to diagnosing and treating wood smoke–related illnesses. A physician is likely to conduct a complete physical examination and compile a patient medical history and list of symptoms. Diagnosis and care will be targeted toward the underlying condition that the smoke aggravates, such as asthma or a particular allergy.

For people affected by wood burning smoke, steps can be taken to reduce exposure to indoor and outdoor smoke pollutants. Should symptoms occur despite these efforts, physician prescribed allergy or asthma medications can be used.

Those affected by wood burning smoke should make a habit of checking the air quality index, a daily measurement of air–quality levels reported by the U.S. Environmental Protection Agency (EPA). Checking air quality is particularly important if there are regional forest fires. Five major pollutants are tracked:

• Ground–level ozone
• Particle pollution (particulate matter)
• Carbon monoxide
• Sulfur dioxide
• Nitrogen dioxide

Air quality for each pollutant is scored on a scale of 0 to 100, with scores representing a level ranging from “good” to “hazardous.” Anything above 100 is considered unhealthy for asthmatics and allergy sufferers. Air quality is also rated as good, medium, unhealthy for certain groups (such as asthmatics), unhealthy, very unhealthy and hazardous.

Those sensitive to wood smoke should take the following precautions when outdoor air quality is poor:

• Limit time outdoors
• Reduce activity level
• Eliminate using wood stoves and fireplaces indoors

People affected by wood burning smoke should avoid burning wood in their homes. Instead a less polluting heating alternative, such as gas-burning appliances, should be used.

Those who are unwilling or unable to use an alternative can reduce their exposure to harmful emissions by following certain steps. These include:

• Use the cleanest technology available. If wood stoves are used, all wood stoves should be EPA certified and professionally installed. These stoves will emit less pollution.
  
  
• Do not use a malfunctioning wood stove or fireplace. Visible smoke or a constant smoky odor indoors is a sign that the wood stove or fireplace is not working properly. Smoke and soot are signs that pollutants are being released indoors.
  
  
• Maintain the wood stove and fireplace. Wood stoves, chimneys and vents should be professionally inspected and cleaned once a year. This can prevent the buildup of creosote (an oily, black tar that can cause toxic emissions).
  
  
• Use smaller pieces of wood instead of one big piece. Smaller pieces burn more efficiently.
  
  
• Use densified fuel logs. According to the EPA, more expensive, manufactured densified fuel logs can reduce emission by 20 to 30 percent. However, the availability of these logs may be limited in some areas.
  
  
• Use wood alternatives. Wood burning fireplaces can reduce emissions by using decorative gas log inserts.
  
  
• Use seasoned hardwoods (e.g., elm, maple, oak) instead of softwoods (e.g., pine, fir, cedar) in wood stoves and fireplaces. Hardwoods may burn hotter and deposit less creosote in chimneys and pipes. However, while many experts recommend this practice, there is currently no laboratory research that conclusively demonstrates the advantage of using hardwoods over softwoods.
  
  
• Do not use green (unseasoned) or wet wood because they produce more moisture, smoke and creosote.
  
  
• Never burn scrap–wood or stained, painted or treated wood as they could release toxic pollutants like arsenic or lead.
  
  
• Never burn plastic, charcoal or colored papers as they also release pollutants.
  
  
• Keep windows open. Windows can be kept open for ventilation while a wood–burning stove or fireplace is used. However, this may not be a good idea if outdoor pollen levels are high.
  
  
• Purchase carbon monoxide detectors. Carbon monoxide detectors are available that will sound an alarm if dangerous levels of carbon monoxide accumulate indoors.

Additional steps for reducing exposure include:

• Try to limit exercise or other strenuous outdoor activities when there are forest fires burning in the region. Exercise involves deep inhalation, which brings pollutants more deeply into the lungs. Also, people exercising tend to breathe through the mouth, where incoming air is not filtered as effectively as it is when breathing through the nose.
  
  
• Reduce particle pollution in the home by not smoking, venting all gas or other combustion appliances directly to the outdoors and not burning wood in the stove or fireplace.
  
  
• Use HEPA filters to capture airborne particles and common allergens in the home. These filters should be regularly maintained to get optimal air quality.
  

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• When a forest or agricultural fire is burning outdoors, avoid using anything that burns including wood stoves, fireplaces and candles indoors. When outdoor air quality is poor it is important to avoid compromising indoor air quality. Vacuuming stirs up particles already indoors and should be avoided at these times as well.

It is unknown whether burning wood may release pollen. People with pollen allergies should avoid burning any wood that releases pollen to which they are allergic. For example, a person with a cedar pollen allergy should not burn cedar in their wood stove or fireplace. This person should also avoid exposure to smoke during a forest fire if cedar trees are present in the area.

Since 1992 the Environmental Protection Agency (EPA) has certified all wood stoves for use indoors to ensure that emissions are not harmful. However, the standards under which the stoves are actually used by consumers do not always match those of the certification process. The EPA standard for wood stove emission certification requires that a successful coal bed preparation be used to produce low burn rates. Failure to use this method can result in significant differences in indoor emissions. However, there is no way to monitor home emissions or ensure that proper preparation methods are used in the home. People using indoor wood burning stoves are encouraged to use the techniques recommended by the EPA.